Red cell concentrates

Dose: in the absence of active bleeding, use the minimum number of units to achieve a target Hb. Assume an increment of 10g/L per unit for an average adult.

In trauma/major haemorrhage scenarios: Hospitals should consider using O D positive red cells for unknown adult male patients

  • R1 Acute Bleeding

    Acute blood loss with haemodynamic instability. After normovolaemia has been achieved/maintained, frequent measurement of Hb (including by near-patient testing) should be used to guide the use of red cell transfusion

  • R2 Hb ≤70g/L stable patient

    Acute anaemia. Consider an Hb threshold of 70g/L and a target Hb of 70‑90g/L to guide red cell transfusion

  • R3 Hb ≤80g/L stable patient and acute coronary syndrome

    Use an Hb threshold of 80g/L and a target Hb of 80‑100g/L

  • R4 Chronic transfusion dependent anaemia

    Transfuse to maintain an Hb which prevents symptoms. Suggest an Hb threshold of 80g/L initially and adjust as required. Haemoglobinopathy patients require individualised Hb thresholds

  • R5 Radiotherapy – maintain Hb ≥ 100g/L

    In patients receiving radiotherapy for cervical, and possibly other tumours

  • R6 Exchange transfusion